By Crystal Watson, Tara Kirk Sell, and Matt Watson
With the release of the President’s Budget Request this week, we now have a glimpse into White House priorities and recommendations for major health security programs. While a detailed analysis will be forthcoming in our annual health security funding article, here is what we know so far:
Centers for Disease Control and Prevention (CDC): There should be a big change at CDC as the Strategic National Stockpile program is moved from its long-time home in the Office of Public Health Preparedness and Response (OPHPR) over to the Assistant Secretary for Preparedness and Response (ASPR). The Public Health Emergency Preparedness (PHEP) Cooperative Agreement program at CDC would receive a $5 million increase above the estimated FY2018 Continuing Resolution (CR) level, while CDC Preparedness and Response would be cut by $20 million, Influenza Planning would get a slight boost, and Emerging and Zoonotic Infectious Diseases programs would be cut by $60 million.
|Centers for Disease Control and Prevention (CDC)|
|Public Health Emergency Preparedness (PHEP) Cooperative Agreements||658.5||655.5||660.0|
|CDC Preparedness and Response Capability (includes BioSense)||161.5||160.7||140.0|
|Strategic National Stockpile (SNS)||573.9||571.1||---|
|Influenza Planning and Response||187.2||171.4||180.0|
|Emerging and Zoonotic Infectious Diseases||575.7||568.3||508.3|
Office of the Assistant Secretary for Preparedness and Response (ASPR): As the new home for the SNS, ASPR’s budget would increase by over $575 million in FY2019. Other programs in ASPR would remain relatively flat, with the Hospital Preparedness Program (HPP) at $255 million (compared to $253 million estimated for FY2018), BARDA receiving about $2 million more than FY2018, and BioShield getting a $3 million increase. Pandemic influenza funding (split between ASPR and the Office of Global Affairs) would increase to a total of $250 million (almost $50 million more than in FY2018).
|Assistant Secretary for Emergency Preparedness and Response (ASPR)|
|Medical Reserve Corps||6.0||6.0||4.0|
|Biomedical Advanced Research and Development Authority (BARDA)||510.0||508.0||512.0|
|Strategic National Stockpile (SNS)||---||---||575.0|
|Preparedness and Emergency Operations||25.0||24.0||27.0|
|National Disaster Medical System (NDMS)||50.0||50.0||50.0|
|Hospital Preparedness (HPP) Grants (includes ESAR-VHP)||254.0||253.0||255.0|
|Policy and Planning||15.0||15.0||15.0|
|Pandemic Influenza (funded between ASPR and OGA)||72.0||112.0||250.0|
Department of Homeland Security (DHS): The major development at DHS is creation of the new Countering Weapons of Mass Destruction (CWMD) Office and reorganization of health-security related programs from across the Department into CWMD. This office was created in December 2017 with the purpose of elevating the CWMD mission within the Department, and providing a centralized office for WMD-related programs. This Office will encompass programs and operations from a number of other parts of the Department, including the Domestic Nuclear Detection Office (DNDO), which will transfer all of its functions to the new CWMD Office; the Office of Health Affairs, which will transfer all of its functions; and the Science and Technology Directorate, which will transfer some of its functions to CWMD. A deeper dive into these budgets will be helpful in understanding what programs were moved, defunded, or kept in place. On initial review, here is what we know:
In total, CWMD’s proposed budget is $429.3 million in FY2019, including:
- $209.3 million for Mission Support and Capability and Operations Support
- Of which, $51.8 million will be for Biological Support, primarily for bio-detection (BioWatch)
- $74.9 million for Procurement, Construction, and Improvements (primarily for radiological detection equipment)
- $80.4 million for Research and Development (primarily for RN detection)
- $64.7 million for federal assistance to federal, state, local, tribal, and territorial partners
For the Science and Technology Directorate, there is a proposed cost-sharing agreement for the National Bioforensic Analysis Center (NBFAC) within National Biodefense Analysis and Countermeasures Center (NBACC), where the FBI would assume operational costs for NBFAC (which is about 40% of NBACC’s total operational costs). In addition, S&T is proposing to transfer responsibility of the National Bio and Agro-Defense Facility (NBAF) Operations in its entirety to the US Department of Agriculture (USDA).
Global Health Security Agenda: Funding for the Global Health Security Agenda in the FY2019 budget would include $59 million designated GHSA funding out of a $109 million budget in the Global Disease Detection line at CDC, and $72.5 million in repurposed Ebola supplemental funds at US Agency for International Development (USAID). GHSA funds for CDC would be on top of any unexpended Ebola supplemental funding at CDC, which expires in FY2019 for that agency.
More to come in our comprehensive Federal Funding for Health Security analysis, published annually in Health Security.